Rural Restaurant Healthy Options Program

University of Iowa Prevention Research Center (PRC)

A road sign printed with the words: Invest in Your Health with a background of apples, peaches, oranges, and kiwi.

A Prevention Research Center Tool Showing Evidence of Effectiveness


Restaurant goers frequently order without much attention to calories or the nutritional content of their food. The rural Restaurant Healthy Options Program, developed by the University of Iowa PRC helps customers make positive food choices by raising awareness of healthy menu options. This cost-effective intervention targets small owner-operated rural restaurants.1

An on-line Healthy Options Toolkit has templates for table signs, which encourage customers to make healthy choices from the usual menu. An optional window sign advertisement alerts the community to the program. The toolkit also includes tips for starting the program, a brochure for restaurant owners, a healthy options logo, and a press release template. The toolkit materials are free, but users must cover the cost of supplies.


A statewide study found that the program had positive effects on some customers’ eating behaviors. Of the 100 restaurants invited to participate in the program, 28% were willing to adopt it.2 The 100 restaurants selected were non-chain and were in rural counties. The majority of restaurants kept the program for at least one year. For those restaurant customers who noticed the signs, 34% reported being influenced by them to make healthy choices.

The top reasons the restaurants gave for adopting the program were: it lets customers know what healthy options the restaurant has, the restaurant already provides healthy options so the program is consistent with this, and the program promotes awareness of nutrition and healthy eating and wanted to help others. The top reasons for not adopting the program were: no time, not interested, no healthy options available, small restaurant with limited resources, and already provide healthy options.

For more information, contact the University of Iowa PRC or visit Healthy Options Toolkit.

1 Gittelsohn J, Lee-Kwan SH, Batorsky B. Community-based interventions in prepared-food sources: a systematic review. Prev Chron Dis. 2013;10:E180.

2 Nothwehr F, Schultz U, Chrisman M, Haines H. Statewide dissemination of rural non-chain restaurant intervention: adoption, implementation, and maintenance. Health Educ Res. 2014;29(3):433–-441.